“What should I get them”
As therapists we hear this all the time.
You know what else we hear often?
“My kids don’t really play with toys.”

Here’s our 2 cents on this as professionals who believe in the power of play. We all play. All mammals. No matter how old. We were designed for play. It’s the best form of stress release. It recharges creative pathways. And most importantly, it brings JOY.

Sometimes as parents the hardest part is finding the right toy for the right kid (or adult). But we believe Santa has the perfect one for everyone. So here’s what we’ve done this week. We’ve made our lists and we’ve checked them twice.

We added toys we have in our homes. Toys we’ve learned about in patient’s homes. Toys recommended by therapists around the globe. And toys that span a large range of interests and prices. Because some toys, just like play, are timeless, we’ve keep some favorites from year to year and we’ve added in new finds.

This year we’ve added 4 NEW special lists. Families often ask us for toys for a specific developmental purpose so we decided to share with you what we share with them. In addition to our lists by age we’ve added lists that suggest specific toys to promote motor, language, and visual development. We also added in a list of favorite games because games promote desperately needed social skills and family game night should be celebrated regularly!

We’ve combined all our lists by age right here for you and hope you’ll find it helpful. What would you add to our lists? What do your kids love?

Don’t forget 1-2-3 Just Play With Me for the expecting or new parents on your list! Empowering them with 3 years of education and purposeful play suggestions is a perfect and practical gift! We ship every day (free in the US. Contact for fair quotes internationally) and can include a customized gift card message just from you!

“What should I get them???”
As therapists we hear this all the time.
You know what else we hear often?
“My kids don’t really play with toys.”

Here’s our 2 cents on this as professionals who believe in the power of play. We all play. All mammals. No matter how old. We were designed for play. It’s the best form of stress release. It recharges creative pathways. And most importantly, it brings JOY.

Sometimes as parents the hardest part is finding the right toy for the right kid (or adult). But we believe Santa has the perfect one for everyone .
So here’s what we’ve done this week.
We’ve made our lists and we’ve checked them twice.

We added toys we have in our homes. Toys we’ve learned about in patient’s homes. Toys recommended by therapists around the globe. And toys that span a large range of interests and prices. Remember that toys and interest vary by age, so something on another list may really interest a child even if it is not included on the list for your child’s particular age.

We’ve given suggestions by age but here we are sharing some of our favorite MOTOR toys! Toys on this list include items that motivate kids to move – both with their larger muscles for gross motor movement (rolling, crawling,walking, running, jumping, climbing and more) and fine motor movement (pointing, plucking, squeezing, scooping and more!) Here’s our picks for this group this year!

Poke A Dot Farm –

Wonderful for promoting isolation of the index finger for pointing – am important fine motor skill!

Hop & Count Hopscotch Rug-

Even when it’s chilly inside, kids can work on balancing and coordination while having fun! Could also be used in non traditional ways by having them jump to a particular color or number.

Climb & Crawl Foam Play Set-

Could be used in many ways from early positioning to toddler tumbling!

Keyboard Play Mat-

Add some music to jumping fun!

Hearthsong Liquid Tiles-
Love these for motivational moving from tummy time to jumping. While they are an investment for the whole set, they can be purchased individually and a few seem like fun!

Knobby Ball Set-
So many motor skills can be taught with a ball – every home should have at least 1! Catch, kick, games, turn taking and more!

Hoola Hoop-

A very simple but versatile toy, they can be used the traditional way or for crawling, stepping, or jumping over and through. Great for directional, “Simon Says” type play and balance and coordination.

Large Fitness Ball-

Great to positioning (with supervision) for young babies, bouncing and playing on for toddlers and kids of all ages, and even alternative seating for meals or homework. One of our favorite ways is playing games over the ball in a plank position to strengthen shoulders (great for handwriting!).

Stomp Rocket-

Fun for balance on one leg and jumping.

Tweezers and Eye Droppers-

Creative fun options are endless while strengthening those tiny hand muscles – color sorting games and activities, art creations, and early science (check out our Pinterest pages for ideas!).

Balance Pods-

Love how these can be moved for simple early motion coordination games (close together for a balance beam, farther apart for indoor stone skipping). Great challenge for older kids can be progressed (stand on one foot and play ball!).

Loved these items for play on the go (restaurant, plane, car, church) because they have few parts. Great for hand strengthening and early language with animal sound imitation.

Dimpl-

The reviews on this fine motor gem are unanimously outstanding. I may just order one for myself for play on the go.

Crawling tunnel-

Wonderful for encouraging crawling and sensory exploration.

First Slide-

I’m a fan on these outside on warm days and inside on cooler ones. Will occupy kids for hours while working on safe climbing and filling sensory needs.

Trampoline-

As a parent, I wouldn’t have survived toddlerhood in the winter without this in my house. As a therapist, I love it for sensory needs and motor coordination and strengthening.

Shopping Cart-

My go to instead of push walkers for babies learning to walk. Allows for free movement and strengthening with the option of weighing down (and gradually reducing weight) as the child gets stronger and needs less help.

Floor Tiles-

So many homes have wood or tile floors leaving parents nervous and young babies hesitant to explore. I love these because they provide a softer surface that is also smooth, making early belly scooting and crawling on hands and knees simpler.

Activity Mat-

Love these for early reaching, batting, and rolling and this one in particular includes colors that baby sees first.

Indoor Swing-

Motor skills progress best when kids get plenty of opportunity to feed their sensory systems and swings are one of many ways to do just that.

Equipment for individuals with special healthcare needs have come a long way. The field is always evolving to higher levels of performance and patient friendly options, but the problem generally still exists that many items are bulky, heavy, and expensive.

A family I work with in early intervention is well equipped with equipment to ensure that their daily activities as a family are as easy as possible, including adaptive seating and mobility options for community outings, playtime, and daily routines like bathing and eating.

With spring finally deciding to show up around here, this family (like many) is busy planning more ways to enjoy time together outside. One area they identified as a challenge was helping their son to sit on their deck and at the park or beach. Yes, they are fortunate to have specialized strollers, but the reality is that for a quick trip, something light or something that doesn’t take up the whole trunk was desired.

Today during our session, for under $10, his mother and I created something that filled the need for his family. If you or someone you know could benefit from something similar, we are happy to share what we did and what we learned.

Supplies:

1 simple plastic chair ($5):

TIPS:

Fit to size for your child.

We preferred one with the bottom lower than the knee area (to prevent sliding).

Highly recommend a chair with slits to help with attaching supports.

2 Pool Noodles ($1 each).

Scissors to cut noodles.

Two bags of large zip ties ($1.87 each).

Plastic or wire cutters to trim zip ties once attached.

Assembly:

We chose to start with the child in the chair and observe his posture. Where did he struggle to maintain neutral and upright positioning?

With him in the seat, cut noodles to accommodate his size and weaker areas. For him this included: back of head, on each side of the trunk under arm pits to base of hips (vertically), on sides of lap from knees to hips (horizontally), a smaller piece on top of these horizontal pieces to support the elbows as needed (these were added after the photo shown above), and a small piece in between the legs as a pummel to prevent sliding.

Attached noodles with zip ties by lacing through chair slits (note: we realized after the fact, but it would be recommended to have the fastener part of the tie on the backside of the chair to prevent rubbing/irritating the skin).

We attached a loose scarf of moms through slits and around his upper trunk, not as a firm support, but a light reminder for him to avoid slouching.

We were thrilled with the results and so was he! With an adaptive tray he could easily access his I-pad (used for vision work and communication) in his new “desk!” His mom and I were quickly able to identify many potential uses – kicking in the baby pool, outdoor movies, on the sidelines at siblings games, at grandma’s house!

We believe play keeps us all happy, healthy, and smart! When I can help adapt something simple to make joyful activities easier for families, it’s just a really good day.

I love working in early intervention for many reasons, but one of the most rewarding is working alongside other passionate therapists. Today I got a call from a long time and skilled colleague, a speech language pathologist who is a feeding expert in our community. She had a question that led to a great discussion that led to this post (why not share helpful convos, right? That’s why we are here). Her question: I’m working with a 2 month old that hates her tummy. I’ll give general recommendations, but when do I need PT support? And why do babies hate being on their bellies so much? And what can we do to make this more pleasant for babies and families?

In my experience, there are several understandable reasons parents tend to avoid tummy time, rooting in real reasons that babies don’t enjoy the position, resulting in real (and incredibly frequent) consequences.

WHY DO PARENTS AVOID TUMMY TIME FOR THEIR BABY?:

FEAR: As a new parent leaving the hospital you are overwhelmed with education on the dangers of letting baby sleep on their belly. It is natural that your first instinct as a new parent is to keep them SAFE. That’s the #1 goal right? I see so many parents avoid tummy time out of fear that their precious, little, fragile baby will not be safe on their tummy. I was this parent. And I am a physical therapist and my husband is an occupational therapist and we STILL avoided it somewhat with baby #1 OUT OF FEAR. I reassurance parents daily (and wish someone had reminded me) that if you are present, awake and alert, and placing baby on a firm surface, being on their tummy from day 1 is not only safe, but beneficial. Here’s WHY.

DISCOMFORT: For many reasons (another post, another day), there are many babies that suffer from acid reflux and colic early on. This can lead to legitimate (and often under recognized pain) and a strong avoidance of a tummy down posture (interestingly some babies with these diagnoses may prefer this posture and find it soothing). If untreated and unresolved the pain from acid reflux often leads parents to avoid placing baby on his/tummy and this ultimately leads to other concerns. If you feel that a baby is genuinely in pain or distress, speak to your pediatrician about your concerns.

CONVENIENCE: Technology and innovation continues to progress as time goes on and the baby industry is not absent from advances. More and more baby “containers” are created that are incredibly efficient at soothing a baby. Often recreating the sensation of the womb, these swings, seats, bouncers, and rockers can keep baby happy and quiet for long periods of time. The result is more time for parents to get some rest and get things done (who doesn’t love and need that? Me too!) However, there is a reason babies fuss. It’s how they communicate early on. It is their way to request what their body needs – food, physical contact, movement etc. If the container does such a good job at soothing them, they often miss out on natural experiences with their caretakers and during play that are SO IMPORTANT and essential for their development. So while we all need some help and convenience from time to time, it’s important to limit time in these containers. More on avoiding the “container shuffle” here.

WHY DO BABIES DISLIKE BEING ON THEIR TUMMIES?:

PAIN: See above. A baby in pain may not like this posture. We can’t stress enough that signs of pain should not be ignored.

SENSORY CONFUSION: When we think of senses, we thing smell, taste, touch, and hearing. But body position and vestibular movement is a large sense represented in the young brain. Our brains seek out what we are used to and familiar with. Many parents tend to wait until 4-5 months when baby seems more stable with more head control to start tummy time. But by this time, this belly down posture, can seem very foreign to a baby who has only been positioning upright or on his/her back. When things seem foreign we tend to make noise. Think of yourself upside down on the occasional roller coaster. It feels weird, and scary – so you scream….same for baby who has never been placed belly down. If tummy time is started from day 1, it is my experience that frequently baby will never complain or dislike it.

POSTURAL IMBALANCES: The longer baby stays in the womb the more restricted they are to movement (no more room in the Inn). So many are born with some postural imbalances where the fascia over the muscles becomes restricted on one side vs. the other (think of your stiff neck on one side when you’ve slept in a “funny” position). In many European countries, they often treat infants with osteopathic adjustments for this very reason before they send them home from the hospital. Often times, these imbalances (if minor) will work themselves out if baby is benefitted with free movement, however if significant, imbalances occur (often presenting as torticollis) baby may be uncomfortable on his/her belly.

CONSEQUENCES OF AVOIDING TUMMY TIME:

DELAYED MILESTONES: Studies show us that babies that have more exposure to free play on the floor meet their milestones earlier. I see this every day. To be frank, this isn’t rocket science. We get better at anything we get to practice. More time on the floor or a firm surface to play allows baby to flex, extend, move in diagonal patterns, and generally get stronger and more coordinated which eventually leads to rolling, crawling, sitting, and walking! I frequently remind parents that they can’t magically roll if they are either held or strapped to some sort of seat all day.

MISSING OUT ON TYPICAL DEVELOPMENTAL EXPERIENCES: Babies are born with primitive reflexes and responses that are replaced with more mature postural reflexes as they move and develop. If these aren’t replaced or fully integrated, there can be lasting consequences. For example, there is a reflex that integrates when a baby crawls. If it does not, seated attention, posture, and hand/eye coordination can be affected. Other benefits can include improved visual coordination and strength, aided digestion, promotion of natural head shape, and development of natural muscular arches in the hand that support eventual skills such as handwriting.

IMPACT ON OVERALL DEVELOPMENT: We focus on gross motor or physical benefits of tummy time which are so important, but we can’t forget the other areas. When babies become mobile on their tummies, they engage in problem solving situations, flexing their cognitive muscles (How can I get to that thing I want across the room), fine motor skills (picking up tiny things they shouldn’t on the ground), and social skills (I WILL get to mom/dad to show them what I want) to start to advocate for themselves and engage with others at will.

STRATEGIES TO MAKE ALL THIS BETTER:

ALTERNATE POSITIONING: Tummy time means belly down – allowing lifting the body against gravity. This doesn’t have to be on the floor. It can be on a parents’ chest, a large yoga ball, over a lap, or on an incline/wedge/Boppy type pillow.

INTERESTING MATERIALS AND ENTICING SETTINGS: Kids always like the paper or the box, right? Save enticing but safe materials for supervised tummy time experiences (bubble wrap taped to the floor, tissue box, kitchen spoon/whisk) and settings (textured blanket, kitchen floor (yes I’m serious), the grass (or any place outside on a blanket), the kitchen table (with parent right next to them – great place for eye contact!).

DO IT EARLY & STOP SCHEDULING IT: My favorite tips include not to schedule it and to start on the day you come home from the hospital. If we make tummy time an “event” on the daily schedule, it’s likely to not happen or only last 10 minutes. I advise parents to always place baby on the floor or Pack-N-Play on the tummy when they set them down vs. a swing or seat. Ay the end of the day, this practice leads to MANY minutes of exposure to play on the belly, and a natural part of the daily routine leading to consistency.

A child’s development is fascinating and exciting. Learn more about what to expect and how to encourage early milestones in a format you will actually have time to read and use. 1-2-3 Just Play With Me is kind of like this post – Mom inspired and therapist created. Hope both are helpful!

https://milestonesandmiracles.com/wp-content/uploads/2017/08/milestones-miracles-logo.jpg00Nicole Sergenthttps://milestonesandmiracles.com/wp-content/uploads/2017/08/milestones-miracles-logo.jpgNicole Sergent2018-02-01 12:39:412018-02-01 20:33:14Don't Add Tummy Time As Another Thing On The Schedule. What a pediatric PT wishes every hospital told new parents.

When working in the homes of families as an EI therapist I notice many things about a family. The longer I’ve done this work in the family’s natural environment, I’ve become more accurate in picking up small cues about the family…things like, What they value. What time of day they like best. What they want to learn from me and our session. What their comfort level is with a therapist sitting on their floor and jumping into their daily routines. The list really could go on forever.

And as a self described people watcher, I’ve come to know that 1) These things really matter in helping me to do a good job, and 2) They vary GREATLY from family to family. There are very few consistent trends when it comes to my interactions with families in their space…with a few exceptions. The largest exception I see is a parent’s desire to make sure their child has what “they need.” This desire seems universal to me. I’m often asked to recommend toys, asked if they have the “right things,” and asked to make gift recommendations for upcoming birthdays or holidays. Despite family income, I see a trend in family’s feeling that their child needs STUFF. And I understand it. Because I am a mom. And I also love toys. And because the companies that market to us as parents want us to think that MORE is MORE.

As therapists, we believe the opposite – LESS IS MORE. Here’s why. A child can more easily access and interact with fewer number or toys that are organized with their corresponding parts. Hear me – this does not mean designer toy organization (unless you want it to), but this could mean using bins and boxes or separate areas on shelves (more tips HERE). It just means that toys, which are the TOOLS for learning, have an intended purpose for the age/developmental stage and that we don’t need 50 toys that do the same thing. Note that the recommended toy age is not always developmentally correct. It’s being set by marketers not pediatricians or developmental therapists with different goals in mind. Just because that box says 3-6 months, does not mean the toy is developmentally appropriate for a 3-6 month old baby. (Interested in what real development looks like at each stage and how to pair it with purposeful play and creative materials? Check out 1-2-3 Just Play With Me We have done that work for you.)

When discussing this, we often talk about THE 4 ESSENTIAL B’S OF EARLY CHILDHOOD. And we’ve challenged ourselves with this question:

What developmental milestone could you not achieve between 0-3 years of age with simply BOOKS, a BALL, a BABYDOLL, and BLOCKS?

Literally we’ve sat around the room with other therapists and challenged ourselves with this question (desperately nerdy, I know) and we can’t find one single milestone.

BLOCKS:oral motor exploration, cause and effect (knocking down), stacking, jumping over, counting, role play when using as other objects (cell phone, people), patterning, spatial awareness. More on the importance of blocks HERE.

As a parent, I encourage you to shed the cloak of stress that “my kid needs more.” Our kids need us. Embrace that thought. It’s quite freeing and leads to memory making experiences no toy can replace.

As a therapist, I encourage other therapists to spread this message. I sat with a young first time, young mom yesterday who asked me to go through a laundry basket filled with an array of toys she had been gifted, purchased, or had been handed down. She, like many parents I know, stressed she didn’t have enough or the right things for her child. We went through that bin together and identified what he might learn from those toys at this stage of development and which might encourage him to do the next exciting thing. And she boxed up the things he had outgrown, was too young for, or had too much of. She was so relieved and I was so excited for her and her child.

Spring cleaning leaves room for new growth. That holds true for our little ones too. Shed the rest and see what fun you can experience today with our 4 essential B’s!

As a pediatric physical therapist working in an early intervention setting, I spend a good amount of time on the stairs. Steep stairs, wide stairs, narrow stairs, wooden stairs, carpeted stairs, baby gate, no gate, one flight of steps, steps broken into two segments, rail on left, rail on right, no rail at all, no steps at all! I’ve studied construction of steps almost as much as my contractor father. I’ve also learned that parents have as many different views on steps as they do on nutrition and discipline. Some are so fearful of their child falling down steps that they are off limits all together. Others refuse a baby gate reasoning that the steps are there so they need to learn to be safe as soon as possible. And then there is everything in between.

If you are a parent with a child ready to take off (and up and over the horizon) of the steps in your home, we have a few tips to share:

Allowing your child to learn to crawl up and down the steps is am important pre-curser to walking them. It allows for the cognitive experience of learning the depth of the step, the distance, the texture etc. through exploration of movement and touch.

Before you let your child crawl up all the steps, let them practice crawling up and down one small “step” in the middle of the room – diaper boxes and small plastic bins work beautifully.

Like stepping, crawling down is typically harder than going up. Moving backwards without relying on your vision to see where you are going is not natural but is the safer option rather than scooting facing forward! Modeling to baby (siblings or yes, you yourself) can help!

Children may chose to walk up and down with both hands on the wall or rail (side stepping) or one (forward stepping). One is not better than the other – allow what feels natural to the child.

SAFETY is essential. We encourage use of baby gates until your child is proficient and that an adult always stands below the child when practicing.

Often times, especially with carpeted steps, the flight of steps appears as one big ramp to children. This may be particularly true if there is any visual challenges with depth perception. Lining the steps with colored masking tape or duct tape and placing a favorite sticker in the middle of each, may help highlight each step as individual and make the task of walking down less scary (and maybe even fun).

Just yesterday I was working with a child who would walk up the steps but not down. Her mother described her as “a mule,” digging her heels in and refusing to walk down no matter what motivators the family tried. Problem is, she is getting too big to carry down the steps. I know she is strong enough to descend a step because she does so with a single step into the home and for fun off an exercise step. So we lined the steps with tape yesterday and placed a snow man sticker on each and she literally walked down on the first try!

I hope that these few simple tips make stair climbing fun and safe within your daily routines. We devote a generous portion of our gross motor cards (the pretty green ones) in 1-2-3 Just Play With Me to stair walking. If you don’t have a copy, make sure you get yours today! We share detailed milestones in 5 developmental domains with fun, purposeful play suggestions in a simple practical format – perfect for a parent or pediatric professional!